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Utilization Review Jobs in Tyler, TX (NOW HIRING)

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Post DD RME * Fully prepped ...

Pharmacy Intern

Tyler, TX ยท On-site

$15.75 - $19.50/hr

Alert pharmacists appropriately for drug utilization reviews, calling and resolving third party rejections and rebilling claims, entering and processing refills and adding patients to Refills on Time ...

Pharmacist- PRN

Tyler, TX ยท On-site

$55 - $66/hr

Conduct drug utilization reviews and collaborate with prescribers when concerns arise. * Deliver compassionate, patient-centered care with professionalism and empathy. Clinical Leadership & Team ...

Grad Pharmacist

Mineola, TX ยท On-site

$13.50 - $16.50/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Grad Pharmacist

Lindale, TX ยท On-site

$13.50 - $16.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Pharmacist- PRN

Tyler, TX ยท On-site

$55 - $66/hr

Conduct drug utilization reviews and collaborate with prescribers when concerns arise. * Deliver compassionate, patient-centered care with professionalism and empathy. Clinical Leadership & Team ...

Grad Pharmacist

Winnsboro, TX ยท On-site

$13.50 - $16.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Pharmacist- PRN

Tyler, TX ยท On-site

$55 - $66/hr

Conduct drug utilization reviews and collaborate with prescribers when concerns arise. * Deliver compassionate, patient-centered care with professionalism and empathy. Clinical Leadership & Team ...

Grad Pharmacist

Mineola, TX ยท On-site

$13.50 - $16.50/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Grad Pharmacist

Winnsboro, TX ยท On-site

$13.50 - $16.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Grad Pharmacist

Mineola, TX ยท On-site

$13.50 - $16.50/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Grad Pharmacist

Winnsboro, TX ยท On-site

$13.50 - $16.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Grad Pharmacist

Lindale, TX ยท On-site

$13.50 - $16.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

Grad Pharmacist

Lindale, TX ยท On-site

$13.50 - $16.75/hr

... drug utilization review (DUR), pharmacy professional standards such as corresponding responsibility and red flag detection. While in the pharmacy, you will assist the pharmacy team to ensure that ...

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Utilization Review information

See Tyler, TX salary details

$20

$39

$65

How much do utilization review jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for utilization review in Tyler, TX is $39.84, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $45.77 per hour, depending on experience, location, and employer.

Is utilization review work from home?

Utilization review jobs can often be performed remotely, especially with the increased adoption of telecommuting in healthcare and insurance industries. Many employers offer work-from-home options, provided the reviewer has the necessary certifications and access to electronic health records or claims systems. However, some positions may require on-site presence for meetings or audits.

What does a utilization review do?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, which can be stressful due to strict deadlines, high accuracy requirements, and the need to balance patient care with insurance policies. The job often requires strong attention to detail, communication skills, and the ability to handle complex cases under time pressure.

What is a utilization review?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What are the key skills and qualifications needed to thrive in utilization review?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Relevant skills include knowledge of medical coding, insurance policies, and strong analytical abilities.
What are the most commonly searched types of Utilization Review jobs in Tyler, TX? The most popular types of Utilization Review jobs in Tyler, TX are:
What are popular job titles related to Utilization Review jobs in Tyler, TX? For Utilization Review jobs in Tyler, TX, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Tyler, TX look for? The top searched job categories for Utilization Review jobs in Tyler, TX are:
What cities near Tyler, TX are hiring for Utilization Review jobs? Cities near Tyler, TX with the most Utilization Review job openings:
Infographic showing various Utilization Review job openings in Tyler, TX as of August 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% In-person job distribution, with an average salary of $82,874 per year, or $39.8 per hour.

Board-Certified Thoracic Surgeon

Dane Street, LLC

Tyler, TX โ€ข On-site

Full-time

Re-posted 10 days ago


Job description

Dane Street is expanding our physician panel! We are seeking a skilled and board-certified Thoracic Surgeon in East Texas to join our team for Post DD RME. This role offers flexible scheduling, allowing you to select or decline assignments based on your availability. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.

Dane Street is a national leader in Post DD RME and peer review services, trusted by insurance carriers and organizations across the country for objective, high-quality medical evaluations.

Key Responsibilities:

  • Thorough review of Medical Records
  • Perform in-person evaluations of patients with issues
  • Respond to clinical queries to support claims management
  • Deliver detailed Post DD RME reports within an expected turnaround time of 5 days

Requirements

        • Board-certification required.
        • Previous experience in performing Post DD RME is preferred.
        • Strong analytical skills and excellent communication abilities are a plus
        • DWC Certified required

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours-conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established, and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Post DD RME
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal

If you are a dedicated Thoracic Surgeon looking for a flexible opportunity to apply your expertise in an IME capacity, we encourage you to apply.